Abstract

Drugs may have either a beneficial or adverse effect on renal function. It is the latter effect we wish to focus on since 10% nephrological consultations involve the possibility of drug-induced renal injury (Porter and Bennett, 1985). Thus information regarding prevalence, clinical presentation, pathophysiological mechanisms of injury and methods of modifying it have become a significant area of research. Most studies are designed to assess the potential risk which a drug possesses for inducing significant nephrotoxicity in a given patient. Since toxicology studies the adverse effects of chemicals on living organisms and assesses the probability of their occurrence, the two expected outcomes of a toxicological analysis are risk assessment and risk prediction. However, clinical toxicology combines the science of toxicology with the art of medicine; thus, the contribution of each is critical in the study of druginduced nephrotoxicity. Scientifically, both the quantitative and qualitative in vivo and in vitro effect of drugs in the kidney are important contributors to the final assessment. However, the answer most often sought i.e., to predict occurrence in man, must occur in the face of limited scientific data as it involves the extrapolation of one set of exposure conditions to another circumstance involving different species.

Christensen, S., Kristensen, A.R., and Faarup, P., 1981, Effects of lithium and neuroleptics and combinations of the two on renal function and structure in rats, Acta Pharmacol. Toxicol., 49:161.CrossRefGoogle Scholar

Harris, C.A. and Jenner, F.A., 1972, Some aspects of the inhibition of the action of antidiuretic hormone by lithium ion in rat kidney and bladder of toad Bufo Marinos, Br. J. Pharmacol., 44:223.PubMedCrossRefGoogle Scholar